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Acute compartment syndrome of the forearm and hand in a patient of spine surgery -A case report-.

Lee JA, Jeon YS, Jung HS, Kim HG, Kim YS - Korean J Anesthesiol (2010)

Bottom Line: The chest roll at the left side had moved cephalad into the axilla and compressed the axillary structures.In the post anesthesia care unit, the radial pulse of the left hand was palpable and the level of oxygen saturation was normal.This compartment syndrome suggests careful attention should be paid to the position of the chest roll when the prone position is established for a long duration.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, St. Vincent Hospital, Catholic University of Korea, Suwon, Korea.

ABSTRACT
A 38-year-old woman underwent a 4-hour operation in the prone position for a laminectomy at C4-7 and posterior cervical decompressive fusion at C7-T1 under general anesthesia. After undraping at the end of surgery, considerable swelling with many blisters of the left forearm and hand was observed. The chest roll at the left side had moved cephalad into the axilla and compressed the axillary structures. An emergency fasciotomy to decompress the compartments of the forearm and dorsal surface of the hand was performed. In the post anesthesia care unit, the radial pulse of the left hand was palpable and the level of oxygen saturation was normal. Forearm and hand edema subsided gradually over several days and the patient was discharged with full function of her left arm. This compartment syndrome suggests careful attention should be paid to the position of the chest roll when the prone position is established for a long duration.

No MeSH data available.


Related in: MedlinePlus

Swollen left forearm and hand with many blisters.
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Figure 1: Swollen left forearm and hand with many blisters.

Mentions: After undraping at the end of surgery, the left forearm and hand of the patient were found to be quite swollen with many blisters (Fig. 1). The left upper extremity was very cool and cyanotic, and the radial pulses were not palpable well. The pulse oximeter did not detect any waveforms on the left hand. Digital capillary refill was found to be delayed compared to the contralateral extremity. The NIBP cuff and left antecubital catheter were removed. A hand surgeon was rapidly consulted and a fasciotomy was performed on the forearm and dorsal surface of the hand to reduce the increased pressure of the compartments. A large amount of fluid, which was likely to be an extravasated crystalloid solution, was drained when the surgeon squeezed the patient's arm during the fasciotomy.


Acute compartment syndrome of the forearm and hand in a patient of spine surgery -A case report-.

Lee JA, Jeon YS, Jung HS, Kim HG, Kim YS - Korean J Anesthesiol (2010)

Swollen left forearm and hand with many blisters.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908229&req=5

Figure 1: Swollen left forearm and hand with many blisters.
Mentions: After undraping at the end of surgery, the left forearm and hand of the patient were found to be quite swollen with many blisters (Fig. 1). The left upper extremity was very cool and cyanotic, and the radial pulses were not palpable well. The pulse oximeter did not detect any waveforms on the left hand. Digital capillary refill was found to be delayed compared to the contralateral extremity. The NIBP cuff and left antecubital catheter were removed. A hand surgeon was rapidly consulted and a fasciotomy was performed on the forearm and dorsal surface of the hand to reduce the increased pressure of the compartments. A large amount of fluid, which was likely to be an extravasated crystalloid solution, was drained when the surgeon squeezed the patient's arm during the fasciotomy.

Bottom Line: The chest roll at the left side had moved cephalad into the axilla and compressed the axillary structures.In the post anesthesia care unit, the radial pulse of the left hand was palpable and the level of oxygen saturation was normal.This compartment syndrome suggests careful attention should be paid to the position of the chest roll when the prone position is established for a long duration.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, St. Vincent Hospital, Catholic University of Korea, Suwon, Korea.

ABSTRACT
A 38-year-old woman underwent a 4-hour operation in the prone position for a laminectomy at C4-7 and posterior cervical decompressive fusion at C7-T1 under general anesthesia. After undraping at the end of surgery, considerable swelling with many blisters of the left forearm and hand was observed. The chest roll at the left side had moved cephalad into the axilla and compressed the axillary structures. An emergency fasciotomy to decompress the compartments of the forearm and dorsal surface of the hand was performed. In the post anesthesia care unit, the radial pulse of the left hand was palpable and the level of oxygen saturation was normal. Forearm and hand edema subsided gradually over several days and the patient was discharged with full function of her left arm. This compartment syndrome suggests careful attention should be paid to the position of the chest roll when the prone position is established for a long duration.

No MeSH data available.


Related in: MedlinePlus